Aa
Hiv, Cunnilingus, Menstruation, Sore throat: Risk
A few days ago I had sex with a Brazilian sex worker. We had sex with a condom after I performed oral sex on her for about 10 minutes. I had a sore throat (inflammation) during this experience. After sex, blood poured from this woman's vagina. I assumed her period had arrived and I could taste blood in my mouth.
I understand that cunnilingus by itself poses very little risk for HIV infection--but I had the added risk factors of her blood and my sore throat present during the experience. Did my sore throat make me much more susceptible to HIV? If it were not for the blood and the sore throat I would not be too worried--but since these additional co-factors were present I am concerned. I would like to know how much of an issue having a sore throat in combination with the blood is--or should I relax about it?
Further, I do plan to get tested once I return to the USA. I plan to get the PCR RNA test. My plan is to get tested exactly 25 days after I was exposed (due to my schedule--I have already contacted the clinic). How confident can I be of the results of this test. Do I need to even get tested in your opinion?
To reiterate, I am not worried about the brief, protected vaginal intercourse I had with this woman. My primary concern are the facts that I had a sore throat and tasted her blood in my mouth. Many websites on the internet indicate that blood and a sore throat up the odds here.
Thank you. Any feedback is very welcome.
I understand that cunnilingus by itself poses very little risk for HIV infection--but I had the added risk factors of her blood and my sore throat present during the experience. Did my sore throat make me much more susceptible to HIV? If it were not for the blood and the sore throat I would not be too worried--but since these additional co-factors were present I am concerned. I would like to know how much of an issue having a sore throat in combination with the blood is--or should I relax about it?
Further, I do plan to get tested once I return to the USA. I plan to get the PCR RNA test. My plan is to get tested exactly 25 days after I was exposed (due to my schedule--I have already contacted the clinic). How confident can I be of the results of this test. Do I need to even get tested in your opinion?
To reiterate, I am not worried about the brief, protected vaginal intercourse I had with this woman. My primary concern are the facts that I had a sore throat and tasted her blood in my mouth. Many websites on the internet indicate that blood and a sore throat up the odds here.
Thank you. Any feedback is very welcome.
MEDICAL PROFESSIONAL
Welcome to our Forum. It sounds as though you have thought about your risks carefully. I hope that you will find my comments helpful as well.
For starters, the first and most critical question is, was your partner HIV infected. I suspect that this is currently unknowable however if you could determine this, it would be most helpful. If she is HIV negative, clearly there is no risk to you. We DO know that HIV is somewhat more common in Brasil than in North America and Western Europe but, nonetheless, it is still more likely than not that she did not have HIV.
But, what if she did. That she had started her menstruation does not change your risk. Many before you have performed oral sex on partners with blood present and this has not lead to HIV transmission. Whether your sore throat changes anything is a bit harder to determine. There are no data that this is the case but, as you might imagine, this has not been specifically studied either. I doubt that it has any impact.
Finally, as for your plans for testing at 25 days. An antibody test at that time will detect somewhere in the neighborhood of 70% of infections acquired about three and a half weeks earlier and an HIV PCR test should add to the proportion of infections detected. How much however is unknown. Despite claims to the contrary made by some companies, the time course of HIV PCR positivity has not been fully described at this time (unlike the time course of antibody development).
Bottom line, your risk is low. When you are tested on the 25th, I anticipate that your test results will be negative. I doubt there is any reason for further testing beyond that other than perhaps for your own peace of mind.
Hope this is helpful. EWH
For starters, the first and most critical question is, was your partner HIV infected. I suspect that this is currently unknowable however if you could determine this, it would be most helpful. If she is HIV negative, clearly there is no risk to you. We DO know that HIV is somewhat more common in Brasil than in North America and Western Europe but, nonetheless, it is still more likely than not that she did not have HIV.
But, what if she did. That she had started her menstruation does not change your risk. Many before you have performed oral sex on partners with blood present and this has not lead to HIV transmission. Whether your sore throat changes anything is a bit harder to determine. There are no data that this is the case but, as you might imagine, this has not been specifically studied either. I doubt that it has any impact.
Finally, as for your plans for testing at 25 days. An antibody test at that time will detect somewhere in the neighborhood of 70% of infections acquired about three and a half weeks earlier and an HIV PCR test should add to the proportion of infections detected. How much however is unknown. Despite claims to the contrary made by some companies, the time course of HIV PCR positivity has not been fully described at this time (unlike the time course of antibody development).
Bottom line, your risk is low. When you are tested on the 25th, I anticipate that your test results will be negative. I doubt there is any reason for further testing beyond that other than perhaps for your own peace of mind.
Hope this is helpful. EWH
Thank you for your feedback, Dr. Hook. It is welcome and helpful. I plan to relax and take some deep breaths until I receive conclusive test results. Happy Holidays.
You are reading content posted in the HIV - Prevention Forum
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
Can I get HIV from surfaces, like toilet seats?
Can you get HIV from casual contact, like hugging?
Frequency of HIV testing depends on your risk.
Post-exposure prophylaxis (PEP) may help prevent HIV infection.
